1. Field of the Invention
This disclosure relates to systems of methods for locating arteriotomies. In some embodiments, the localization is used for therapeutic targeting (e.g., for targeting of high-intensity focused ultrasound).
2. Description of the Related Art
Certain medical procedures result in bleeding penetration wounds inside the body, for example via the insertion of devices into blood vessels and/or organs. Representative procedures include arterial and venous catheterization for cardiologic or radiologic interventional procedures, needle biopsy procedures, and minimally invasive surgery. Improved percutaneous catheterization techniques have enabled physicians to perform an ever-increasing number of diagnostic and therapeutic cardiovascular procedures using devices deployed through arteries and veins. The annual number of therapeutic and diagnostic catheterization procedures worldwide is over 14 million and it is continuously growing.
In the vast majority of these catheterization procedures, access to the vasculature is accomplished by percutaneous installation of an introducer sheath into the common femoral artery. The introducer sheath facilitates passage of a variety of diagnostic and therapeutic instruments and devices into the vessel and its tributaries. At the conclusion of the catheterization procedure, the introducer sheath is removed, leaving an arteriotomy that must be sealed. Arteriotomy hemostasis is most often (approximately two-thirds of all cases) achieved by the application of manual or mechanical compression (standard compression) on the puncture site until a stable clot forms. Several important limitations are associated with the use of standard compression. For example, a physician, nurse, or trained technician must apply digital pressure on the access site for up to 40 minutes. Patients must remain on bed rest for three or more hours so as not to disrupt clot formation in the arteriotomy. The most painful aspects of the catheterization procedure reported by patients are the standard compression procedure and lying immobile for hours. The aggressive use of anticoagulants and antiplatelet therapies to prevent thrombus formation during catheterization procedures has greatly increased the difficulty of sealing the access site using compression. Finally, complications occur, the most frequent of which are the formation of hematomas, pseudo-aneurysms, and/or arteriovenous fistulae.
Products for sealing arteriotomies based on newer technologies such as collagen plugs, sealants and mechanical suturing are being successfully marketed. However, these products are invasive, implant foreign materials, require skill and training to use, and can cause major complications. Accordingly, there is a need for improved systems and methods for sealing arteriotomies